Interprofessional education: effects on professional practice and healthcare outcomes (update)

Unpacking the perceptions and experiences of student facilitators in interprofessional education: a qualitative study

Enhancing health professional students' effective learning and collaborative practice requires a deep understanding of strategies for facilitating interprofessional learning. While faculty members and clinical preceptors are recognized as facilitators in interprofessional education (IPE), there is limited knowledge about the impact of student facilitators' engagement in IPE. Accordingly, this study aims to explore the perceptions and experiences of student facilitators in IPE. Thirteen student facilitators were recruited to lead an interprofessional learning program, and they were subsequently invited to participate in one-on-one interviews. An interview guide was developed to explore their motivations, expectations, engagement, effectiveness, and achievements in IPE facilitation. Thematic analysis was conducted using MAXQDA software to analyze the student facilitators' experiences and perceptions. Eight interviewees from various disciplines, including Medicine, Nursing, Pharmacy, Speech and Hearing Sciences, and Social Work, took part in the study. The findings revealed that student facilitators highly valued their IPE facilitation experience, which aligned with their expectations and led to the creation of social networks, increased confidence, improved understanding of other professions, and the development of lifelong skills. Furthermore, the student facilitators demonstrated cognitive and social congruence by establishing a relaxed learning environment, displaying empathetic and supportive behaviors, and using inclusive language to engage IPE learners in group discussions. This study provides a comprehensive understanding of the role of student facilitators in IPE, contributing to the evolving literature on IPE. A conceptual framework was developed to explore the entire facilitation experience, encompassing the motivations and expectations of student facilitators, their engagement and effectiveness, and the observed achievements. These findings can inform the development of peer teaching training in IPE and stimulate further research in identifying relevant facilitator competencies for optimal delivery of IPE.

Integrated Case Presentation Seminar: Bridging Parallel Fields to Improve Psychiatry and Psychology Learner Experience

Daily clinical practice of mental health professionals often requires interaction between providers from diverse training and professional backgrounds. Efforts to engage mental health trainees across disciplines are necessary and have had varied outcomes. The current study reviews the development and implementation of a monthly one-hour integrated case presentation seminar (ICPS) as part of independent psychology and psychiatry two-year fellowships at a Midwestern teaching hospital. The training integrated a semi-structured seminar to facilitate case presentation within a group setting. The focus of the seminar was to allow for exposure to conceptualization, diagnostic, and treatment strategies and skills, as well as science-based practice techniques for trainees. Learner survey results and the sustained offering of the seminar suggest the format and goals of the seminar are feasible and acceptable. Based on the current preliminary findings, similar training programs may find benefit in strategies to enhance integrated training opportunities for psychiatry and psychology trainees.

Collaborative teaching among ultrasonographers, anesthesiologists, and vascular surgeons: its unique role in specialty training for vascular surgeons in developing countries

This study explored the unique role of collaborative teaching among ultrasonographers, anesthesiologists, and vascular surgeons in the training of vascular surgeons in developing countries. Using qualitative research methods, data were collected through in-depth interviews and observations to analyze the improvement in ultrasound operational skills and basic anesthesia skills among trainees, as well as their satisfaction with collaborative teaching. The results indicate that collaborative teaching significantly enhances trainees' professional skills and interdisciplinary collaboration abilities, gaining widespread recognition from trainees. This teaching model provides trainees with a comprehensive learning experience through interdisciplinary cooperation, hands-on practice, contributing to the cultivation of vascular surgeons with comprehensive qualities and professional competencies. This study offers new ideas and methods for the training of vascular surgeons in developing countries, holding significant implications for the development of medical education.

The significance of a dialectical approach to enrich health professions education

The Lancet Global Independent Commission has called for a systems-based approach to health professions education. They emphasised the acquisition of collaborative skills, critical reasoning and ethical conduct to prepare students for interprofessional collaborative practice (IPCP). Interprofessional education (IPE) has been put forward as a promising strategy. However, despite the global efforts to incorporate IPE in health professions education curricula, the evidence for a positive impact on IPCP is still inconclusive. This may be related to the misalignment between competency-driven IPE programs that focus on end-stage professional competence and the non-linear development of students' competence that is necessary for the dynamical nature of IPCP. Therefore, we argue that health professions education, and IPE in particular, needs to incorporate these dynamical processes including social and organization sensitivity. We present a conceptual framework that integrates the Cultural-Historical Theory, the principles of dialectical thinking and the concept of metastable attunement. While dialectical thinking is the ability to perceive the complexity of a dynamic reality that is in a state of constant transition, metastable attunement refers to the consequent adjustment to it. The subsequent instructional design employs a dialectical approach to teaching and learning, based on mediating activities and dialectical inquiry. To reach the full potential of this approach, the mediating activities should ensure a continuum of learning across the curriculum. In addition, faculty development needs to focus on the principles of dialectical inquiry as a pedagogy to optimally guide students. Further research into the extent to which healthcare professionals and students think dialectically may inform improvements to the proposed instructional design, the structure of the learning continuum and the essential requirements for faculty development.

Perceptions and influencing factors of interprofessional collaboration in final-year health science students

Interprofessional education (IPE) is vital for preparing a competent health workforce. Despite the proven benefits of interprofessional collaborative practice (IPCP), barriers to its implementation persist. Given the importance of health professionals' perspectives for IPCP success, we investigated the perceptions of IPCP among final-year health science students at Khon Kaen University, Thailand, while they transition into practice. A cross-sectional online survey conducted from February to April 2023 included 989 students across six health science disciplines, with a response rate of 57.8%. Using the SPICE-R2 questionnaire on a five-point Likert-type scale, we assessed perceptions related to interprofessional teamwork, roles and responsibilities, and patient outcomes. Results showed significant diversity in IPCP perceptions and experiences with IPE. Nursing students consistently demonstrated the highest IPCP perceptions, while medical and public health students scored the lowest. Positive perceptions about IPCP were notably associated with nursing students and those satisfied with the learning process. Dentistry students and those with IPE experience also exhibited more favorable views on teamwork. This study suggests the need to address disparities in IPCP perceptions among student groups, which is essential for enhancing interprofessional collaboration in future health professionals.

A longitudinal study of interprofessional education experiences among health professional graduates

Effective teamwork and collaboration among health professionals is a well-recognized strategy toward enhancing patient outcomes. However, there is a lack of understanding on how to best prepare health professionals for collaborative practice. The aim of this research is to gain a better understanding of how graduates of five health professions (dentistry, medicine, nursing, pharmacy, physiotherapy) perceive and experience interprofessional education for collaborative practice (IPECP) throughout their health professions journey, with a focus on transition to practice. This longitudinal study employed an interpretive, narrative methodology to understand interprofessional identity development of 24 individuals who had recently graduated from a health professions program (dentistry, medicine, nursing, pharmacy, physiotherapy) at a Canadian university. Participant experiences were analyzed using narrative analysis. Participants' narratives provided insight into the context, factors and curricular experiences needed for interprofessional identity development and preparedness for collaborative practice. Participants identified the importance of socialization and connection with others, collaborative role models and exposure to collaborative experiences and settings for interprofessional practice. Participants expressed some dissatisfaction with their earliest IPECP experiences and most valued their exposure to 'real-life' practice examples and clinical scenarios. Participants desired more authentic experiences of interprofessional collaboration during their programs. Improving health professionals' interprofessional socialization and collaborative experiences within IPECP is critical to improving patient outcomes. Study findings can inform future curricula and IPECP strategies that create conditions to enhance collaborative practice and ensure the preparedness of a future health workforce with a strong collaborative identity.

How does interprofessional education affect attitudes towards interprofessional collaboration? A rapid realist synthesis

Interprofessional collaboration (IPC) in healthcare is regarded as important by professionals, as it increases the quality of care while decreasing costs. Interprofessional education (IPE) is a prerequisite for IPC and influences learners' attitudes, knowledge, and collaboration skills. Since attitudes shape behavior, understanding how they are formed is crucial for influencing IPC in learners' professional practice. We investigated what kind of IPE works, for which students, how, and in what circumstances to develop positive attitudes towards IPC. Using realist synthesis, we extracted causal mechanisms that produce positive attitude outcomes and the conducive contexts that trigger them. Our analysis resulted in six plausible context-mechanism-outcome configurations that explain positive attitude development. Positive IPC attitudes are more likely to arise in contexts where IPE provides time and facilities for formal and informal interactions, as this allows learners to get to know each other both professionally and personally, fostering trust, respect, and mutual liking. Additionally, positive attitudes are more likely in contexts where the IPE curriculum is perceived as career-relevant and boosts confidence. Key mechanisms of positive attitude development include getting to know the other learners professionally and personally, experiencing positive affect during IPE, and learners experiencing mutual dependence. Sustained positive attitudes are more likely to develop when there is organizational support for IPC and professionals attend IPE on an ongoing basis, allowing the attitudes and values expected in IPC to be positively reinforced and eventually integrated into the learners' personal value system.

Interprofessional education in cardiothoracic surgery: a narrative review

Interprofessional education, an approach where healthcare professionals from various disciplines learn with, from, and about each other, is widely recognized as an important strategy for improving collaborative practice and patient outcomes. This narrative review explores the current state and future directions of interprofessional education in cardiothoracic surgery. We conducted a literature search using the PubMed, Scopus, and Web of Science databases, focusing on English-language articles published after 2000. Our qualitative synthesis identified key themes related to interprofessional education interventions, outcomes, and challenges. The integration of interprofessional education in cardiothoracic surgery training programs varies across regions, with a common focus on teamwork and interpersonal communication. Simulation-based training has emerged as a leading modality for cultivating these skills in multidisciplinary settings, with studies showing improvements in team performance, crisis management, and patient safety. However, significant hurdles remain, including professional socialization, hierarchies, stereotypes, resistance to role expansion, and logistical constraints. Future efforts in this field should prioritize deeper curricular integration, continuous faculty development, strong leadership support, robust outcome evaluation, and sustained political and financial commitment. The integration of interprofessional education in cardiothoracic surgery offers considerable potential for enhancing patient care quality, but realizing this vision requires a multifaceted approach. This approach must address individual, organizational, and systemic factors to build an evidence-based framework for implementation.

Developing pre-licensure interprofessional and stroke care competencies through skills-based simulations

Interprofessional collaboration (IPC) in stroke care is accepted as best practice and necessary given the multi-system challenges and array of professionals involved. Our two-part stroke team simulations offer an intentional interprofessional educational experience (IPE) embedded in pre-licensure occupational therapy, physical therapy, pharmacy, medicine, nursing and speech-language pathology curricula. This six-year mixed method program evaluation aimed to determine if simulation delivery differences necessitated by COVID-19 impacted students' IPC perception, ratings, and reported learning. Following both simulations, the Interprofessional Collaborative Competency Assessment Scale (ICCAS) and free-text self-reported learning was voluntarily and anonymously collected. A factorial ANOVA using the ICCAS interprofessional competency factors compared scores across delivery methods. Content and category analysis was done for free-text responses. Overall, delivery formats did not affect positive changes in pre-post ICCAS scores. However, pre and post ICCAS scores were significantly different for interprofessional competencies of roles/responsibilities and collaborative patient/family centered approach. Analysis of over 10,000 written response to four open-ended questions revealed the simulation designs evoked better understanding of others' and own scope of practice, how roles and shared leadership change based on context and client need, and the value of each team member's expertise. Virtual-experience-only students noted preference for an in-person stroke clinic simulation opportunity.

The effect of interprofessional education on the work environment of health professionals: a scoping review

To explore the existing literature on the effect of Interprofessional Education (IPE) on the work environment of health professionals. The research question was systematized according to the PCC (Population, Concept, and Context) format. A scoping review was performed. A search of multiple bibliographic databases identified 407 papers, of which 21 met the inclusion criteria. The populations of the 21 studies reviewed were composed of professionals in the fields of medicine, nursing, psychology, occupational therapy, physiotherapy, and social work, among others. The study contexts were both academic and nonacademic hospitals, mental health institutions, and community settings, and the topics examined were organizational climate, organizational culture, organizational attachment and job satisfaction. The findings from the reviewed studies showed positive effects of IPE interventions on organizational climate and culture, but the results on job satisfaction and organizational attachment were mixed (i.e., positive and no effects following IPE interventions). Research on IPE is worth more attention as IPE could be an effective alternative for the fulfillment of the Quadruple Aim and achieving the third of the United Nations Sustainable Development Goals, aimed at improving health and well-being. It seems critical for IPE to be positioned as a trend in global health, aiming at boosting human health resources as one of its building blocks and calling the attention of health decision-makers.

Mitigating Misinformation Toolkit: Online Simulation and Standardized Patient Cases for Interprofessional Students to Address Vaccine Hesitancy and Misinformation

Introduction

Medical misinformation, which contributes to vaccine hesitancy, poses challenges to health professionals. Health professions students, while capable of addressing and advocating for vaccination, may lack the confidence to engage with vaccine-hesitant individuals influenced by medical misinformation.

Methods

An interprofessional in-person simulation activity (90 minutes) using standardized patients was developed and instituted for students in medicine, nursing, pharmacy, and public health programs. Student volunteers were recruited from classes approximately halfway through their respective degree programs (i.e., second or third year of a 4-year program). Online simulation was used as a method to prepare for in-person simulation. Impact on students was assessed primarily through a postprogram student self-assessment.

Results

A total of 220 students participated in the program; 206 (94%) had paired data available to analyze. Following program participation, self-assessed abilities increased from pre to post, from 2.8 out of 5 (good) to 3.9 out of 5 (very good; p < .001). Ninety-eight percent of students felt that their ability to address medical misinformation was somewhat/much better after the activity, compared to before, and that their ability to address vaccine hesitancy was somewhat/much better. The overall program was rated highly, with mean scores for each program evaluation item >4 out of 5 (very good).

Discussion

An interprofessional cohort of students demonstrated improvement in self-assessed skills to participate in a conversation with an individual with hesitancy to receive vaccines and/or beliefs informed by misinformation. Students felt that this program was relevant and important to their professional development.

Learner experiences of identity and global interdependence following engagement with an interprofessional education course

University core curricula and accreditation standards for healthcare profession programs can be challenging to align. Additionally, interprofessional education (IPE) requirements for healthcare professions curricula have been designed to prepare learners for future practice. This paper describes alignment of an introductory IPE course with embedded Interprofessional Education Collaborative core competencies to specific university Core Curriculum attributes. A cross-sectional, mixed methods design was used to examine 117 learners' reflections on the IPE course content and learning outcomes. Learners from seven pre-licensure health professions programs provided responses on aspects of their IPE learning experience through reflections, surveys, written examinations, and optional focus groups. Open-ended responses were interpreted thematically from a constructivist lens. Results revealed positive perceptions of the course with feedback for areas of consideration for future course activities. Learners reported more engagement with the Core Curriculum attribute of Identities in Context than that of Global Interdependence. Additionally, responses indicated a perception of task work versus teamwork within the interprofessional team activities. Outcomes provided data that enabled continuous quality improvement of the course. Educators seeking to align IPE courses with institutional core curricula and accreditation standards may use this work to inform structure, assessment, and delineation of teamwork as compared to task work.

The impact of using an authentic patient video on health professional students' attitudes toward interprofessional and person-centered care

Authentic patient activities in an interprofessional education (IPE) setting can develop collaborative, practice ready health professionals who have the skills to work within and across teams with patients at the center of their care. In this qualitative study, the student experience of a novel interprofessional case study activity, with lived experience content delivered via an authentic patient video was explored. Transcripts were analyzed using reflexive thematic analysis and identified three major themes: (a) from disease-centered to person-centered care, (b) reflecting on roles in interprofessional collaborative practice, and (c) teamwork and lived experience facilitates learning. When considered within the Interprofessional Education Collaborative (IPEC) framework, the student experience suggested positive change in all four core competencies: interprofessional communication, values and ethics, roles and responsibilities and teamwork. In addition, students highly valued the interprofessional learning experience, and the patient video created a more realistic case study by reducing clinical assumptions. In conclusion, a short, single exposure to a written case followed by an authentic patient video in an IPE setting had an immediate positive impact on entry-level student health professionals. This simple methodology is a viable way of bringing the authentic patient voice into the classroom with additional benefit from the interprofessional format.

A critical interpretive synthesis of interprofessional education interventions

Interprofessional practice can look quite different depending on a number of dynamics. Interprofessional education interventions may or may not orient toward this range of practice possibilities. This literature review explores: (1) how interprofessional education interventions relate to different kinds of interprofessional practice and (2) the range of interprofessional practices assumed by interprofessional education interventions. Four databases were searched for articles published between 2011-2021 describing pre-licensure level interprofessional education interventions, resulting in a dataset of 110 articles. Our analysis involved (1) descriptive summaries of the articles, and (2) content analysis of the rationale and description of the intervention. Of the articles, 93% (102/110) of interprofessional education interventions were designed and/or evaluated using the concept of interprofessional education competencies. "Teamwork" was the most relied upon competency. Most articles were not explicit about the different kinds of interprofessional practices that these competencies might be oriented toward. Our study substantiates earlier claims that interprofessional education literature tends to focus on competencies and orient toward undifferentiated understandings of "teamwork." This analysis is particularly important as interprofessional teams are engaging in increasingly complex, fluid, and distributed forms of interprofessional practice that may not be captured in an undifferentiated approach to "teamwork."

Unpacking interactions among student teams in a practice-based IPE setting: a qualitative evaluation study

In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions.

Sharpening the lens to evaluate interprofessional education and interprofessional collaboration by improving the conceptual framework: a critical discussion

It has been difficult to demonstrate that interprofessional education (IPE) and interprofessional collaboration (IPC) have positive effects on patient care quality, cost effectiveness of patient care, and healthcare provider satisfaction. Here we propose a detailed explanation for this difficulty based on an adjusted theory about cause and effect in the field of IPE and IPC by asking: 1) What are the critical weaknesses of the causal models predominantly used which link IPE with IPC, and IPE and IPC with final outcomes? 2) What would a more precise causal model look like? 3) Can the proposed novel model help us better understand the challenges of IPE and IPC outcome evaluations? In the format of a critical theoretical discussion, based on a critical appraisal of the literature, we first reason that a monocausal, IPE-biased view on IPC and IPC outcomes does not form a sufficient foundation for proper IPE and IPC outcome evaluations; rather, interprofessional organization (IPO) has to be considered an additional necessary cause for IPC; and factors outside of IPC additional causes for final outcomes. Second, we present an adjusted model representing the "multi-stage multi-causality" of patient, healthcare provider, and system outcomes. Third, we demonstrate the model's explanatory power by employing it to deduce why misuse of the modified Kirkpatrick classification as a causal model in IPE and IPC outcome evaluations might have led to inconclusive results in the past. We conclude by applying the derived theoretical clarification to formulate recommendations for enhancing future evaluations of IPE, IPO, and IPC. Our main recommendations: 1) Focus should be placed on a comprehensive evaluation of factual IPC as the fundamental metric and 2) A step-by-step approach should be used that separates the outcome evaluation of IPE from that of IPC in the overarching quest for proving the benefits of IPE, IPO and IPC for patients, healthcare providers, and health systems. With this critical discussion we hope to enable more effective evaluations of IPE, IPO and IPC in the future.

Exploring Interprofessional Collaboration in Teaching Between Nursing and Physical Therapy

BACKGROUND

Integrating interprofessional concepts and competencies in the classroom teaches students to perform successfully in complex interprofessional care environments. There is little information regarding the effects of interprofessional collaboration in education utilizing faculty and students from other disciplines.

METHOD

Satisfaction and Self-Confidence in Learning Survey (SCLS) scores and written responses were collected from 31 nursing students to explore nursing students' perceptions of an interprofessional collaboration in teaching between nursing and physical therapist (PT) educators.

RESULTS

Nursing students' SCLS scores were higher on days where PT educators participated in teaching students. Analysis of written responses revealed five themes: appreciation of an outside expert perspective, enhanced self-efficacy with patient mobility skills, opportunity for interprofessional collaboration, satisfaction with the learning experience, and conflicting information.

CONCLUSION

Interprofessional collaboration in teaching resulted in high levels of satisfaction and self-confidence and provided an opportunity to work toward an aspect of core competency for interprofessional collaborative practice. [J Nurs Educ. 2024;63(6):402-404.].

Let's Learn Together! A Mixed-Methods Study to Assess Readiness for Interprofessional Education on Total Worker Health® Practice

BACKGROUND

Occupational safety and health (OSH) professionals increasingly need interdisciplinary collaborative practice competencies to respond to complex worker safety, health, and well-being risks. Effective collaboration with non-OSH-trained professionals (e.g., health promotion, human resources) is critical for planning integrated interventions that address work and non-work risks, consistent with a "Total Worker Health" (TWH) approach. Interprofessional education (IPE) pedagogy offers skill-building for interdisciplinary collaboration, but little attention has been given to IPE in OSH education and training literature. The goal of this study was to assess OSH professionals' perceptions about IPE to guide application in postgraduate TWH education.

METHODS

The mixed-methods study involved 210 U.S. professionals in safety (31%), industrial hygiene (16%), occupational nursing (12%) and medicine (11%), and related disciplines (30%). Participants completed a 12-item Readiness for Interprofessional Education Scale (RIPLS) adapted for TWH. Nineteen survey-takers also participated in virtual focus groups to share opinions about IPE benefits, barriers, and desirable course features.

FINDINGS

Occupational safety and health professionals reported high overall readiness for IPE (RIPLS, 4.45 ± 0.47), endorsing IPE for interdisciplinary skill-building. Salient IPE motivators were learning new perspectives from diverse disciplines and industries; gaining new subject expertise; developing common ground across disciplines; and learning TWH best practices. Participants recommended case studies to practice interdisciplinary problem-solving through group work.

CONCLUSIONS/APPLICATION TO PRACTICE

Interprofessional education is a promising pedagogy for OSH continuing education to promote interdisciplinary collaboration skills needed for TWH practice in the workplace. Occupational safety and health educators need to build competency in IPE pedagogical theory and practice to ensure effective training design and evaluation.

Joint interprofessional education of pharmacy and dietetics undergraduates - a scoping review

INTRODUCTION

Interprofessional education (IPE) is an integrative approach that enables collaboration of students of two or more different health professions in aim to acquire skills and competencies related not only to their field of study but also to ensure the standard of care based on collaborative practice. IPE has not yet been explored in relation to collaboration between dietetics-nutrition and pharmacy students, while there is evidence that in many cases nutrition is complementary to pharmacotherapy in the treatment process.

AIM

The aim of this scoping review was to gather, describe and discuss all relevant literature regarding joint interprofessional training of pharmacy and dietetics-nutrition undergraduates.

METHODS

We performed a literature search for studies where IPE between dietetics-nutrition and pharmacy students was described. 2204 articles on this topic were identified. After eligibility assessment, 8 articles were included in the review.

RESULTS

Eight studies were included in the review. Two of these described IPE activities between dietetics and pharmacy students only. The included studies varied in setting, methodology and outcome measures and covered a wide range of topics relevant to clinical practice, such as management of inflammatory bowel diseases, care of the older adults or counselling skills. The most common teaching method was the use of case studies. Some of the included studies did not identify specific learning objectives. The most common way of gathering feedback from participants was through questionnaires and interviews.

CONCLUSIONS

IPE of pharmacy and dietetics-nutrition students is feasible and may be beneficial in many aspects related to learning. However, there is no well-established model or standard that would facilitate the implementation of such activities in individual educational institutions.

Systematic approach to contextualize findings of flexible endoscopic evaluation of swallowing in neurogenic dysphagia- towards an integrated FEES report

Flexible endoscopic evaluation of swallowing (FEES) is one of the most important methods for instrumental swallowing evaluation. The most challenging part of the examination consists in the interpretation of the various observations encountered during endoscopy and in the deduction of clinical consequences. This review proposes the framework for an integrated FEES-report that systematically moves from salient findings of FEES to more advanced domains such as dysphagia severity, phenotypes of swallowing impairment and pathomechanisms. Validated scales and scores are used to enhance the diagnostic yield. In the concluding part of the report, FEES-findings are put into the perspective of the clinical context. The potential etiology of dysphagia and conceivable differential diagnoses are considered, further diagnostic steps are proposed, treatment options are evaluated, and a timeframe for re-assessment is suggested. This framework is designed to be adaptable and open to continuous evolution. Additional items, such as novel FEES protocols, pathophysiological observations, advancements in disease-related knowledge, and new treatment options, can be easily incorporated. Moreover, there is potential for customizing this approach to report on FEES in structural dysphagia.

An evaluation of the psychometric properties of the Australian Collaborative Practice Assessment Tool

OBJECTIVES

This study aimed to validate the Collaborative Practice Assessment Tool (CPAT) in the Australian setting and provide a quality instrument in terms of psychometric properties that can be used to measure interprofessional outcomes for both healthcare practitioners and students. The outcomes evaluated include the capacity to work in an interprofessional team, good interprofessional communication skills, leadership skills, ensuring clear division of tasks and roles in a team, effective conflict management, and being actively involved with patients and their families/communities in care.

METHODS

The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) taxonomy and standards were used as guides for evaluating the psychometric properties of the Australian CPAT, which include evaluations regarding instrument development requirements of sample target and size, content validity, internal structure (structural validity, internal consistency reliability and measurement invariance), and hypotheses testing. CPAT Australia was developed through two stages involving pilot studies and a validation study, both of which included healthcare practitioners and students as participants. A pilot study examined content validity regarding item relevance, item comprehensibility, and instrument comprehensiveness. The validation study was carried out to assess the internal structure of CPAT Australia for aspects of structural validity, internal consistency reliabilities, and configural, metric and scalar measurement invariance. The structural validity was explored using the following three steps: exploratory, confirmatory, and multi-group factor analysis. Construct validity was evaluated to confirm direct and indirect paths of assumptions based on a previously validated model. Data collected between August 2021 and May 2022.

RESULTS

The content validity evaluation confirmed that all items were relevant, understandable and comprehensive for measuring interprofessional collaborative care in Australia. Three hundred ninety-nine participants contributed to the validation study (n=152 practitioners; n=247 students). The original instrument model of 8-Factor 56-Item was improved in the Australian CPAT. Two items, Item 27 (Physicians assume the ultimate responsibility) and Item 49 (Final decision rest with the physician), were consistently rejected and therefore discarded. The internal structure of the 7-Factor 54-Item solution was confirmed as a suitable model with fit indices meeting COSMIN standards for a good model in practitioner and student cohorts. Configural, metric and scalar invariances were confirmed, indicating the invariance of the instruments when used for the practitioner and student cohorts. The construct validity evaluation indicated that 81.3% of direct and indirect assumptions were accepted, fulfilling the COSMIN requirement of >75% of proposed assumptions being accepted.

CONCLUSION

The Australian CPAT with a 7-factor 54-item solution was confirmed as a quality measure for assessing interprofessional education and collaborative practice for both healthcare practitioners and students in Australia with robust psychometric properties.

Interprofessional Curriculum Delivery: Experience of a Primary Care Education Program

Few post-graduate training programs offer a comprehensive curriculum that includes structured clinical experiences to teach interprofessional care. To address this need, the United States Department of Veterans Affairs, Office of Academic Affiliations funded the Centers of Excellence in Primary Care Education (CoEPCE) from 2011-2019 to provide interprofessional curricula for health profession trainees (HPTs), including physician residents, nurse practitioner residents, pharmacy residents, and psychology residents. We examined changes over time in curricular domains, system impacts, and program practices based on HPT survey data and the qualitative evaluation of narrative feedback. An annual survey was administered to participants. Indirect standardized ratios were calculated for interprofessional professional education (IPE) program domains, system impacts, and program practices. Qualitative responses were coded based on curricular domains and key program components. The study cohort included 369 HPTs. Site and profession standardized indirect ratios across all professions indicated improvements in curricular domains, system impacts, and program practices, with significant differences observed for associated health HPTs as compared to other HPTs for performance improvement. Qualitative data indicated that profession was associated with differences in perceptions of the curriculum. Although improvements occurred over time, our findings support the need for the thoughtful consideration of profession-specific identity characteristics when designing interprofessional curricula.

Interprofessional ward rounds in an adult intensive care unit: an appreciative inquiry into the central collaboration between the consultant and the bedside nurse

Done well, ward rounds (WRs) promote effective, safe care and collaboration; but WR quality varies. An improvement-focused appreciative inquiry (AI) into a large intensive care unit's WR practices identified a pivotal axis of collaboration between the most senior medical role (the consultant) and the bedside nurse (BSN). This paper examines that axis of interprofessional collaboration (IPC) to deepen understanding of its implications. Data included ethnographic observations, interviews, and co-constructed AI with groups of staff. Four key concepts emerged from cyclical interpretive analysis: "need," "presence," "ability" and "willingness." BSNs and consultants needed the interprofessional WR to enable their work; WR effectiveness was affected by whether they were both present, then able and willing to participate in IPC. BSN presence was necessary for effective and efficient IPC between these key roles. Indirect contributions, based on prior exchanges with colleagues or through written notes, reduced the joint problem-solving through discussion and negotiation that characterizes IPC to less efficient asynchronous interprofessional coordination. Factors affecting "presence," "ability" and "willingness" are discussed alongside potential mitigations and acknowledgment of asymmetric power. Appreciative examination of interprofessional WRs identified mechanisms supporting and undermining effective WR IPC and the centrality of consultants' and BSNs' collaboration.

Lessons in clinical reasoning - pitfalls, myths, and pearls: shoulder pain as the first and only manifestation of lung cancer

OBJECTIVES

Lung cancer is the leading cause of cancer-related death and poses significant challenges in diagnosis and management. Although muscle metastases are exceedingly rare and typically not the initial clinical manifestation of neoplastic processes, their recognition is crucial for optimal patient care.

CASE PRESENTATION

We present a case report in which we identify the unique scenario of a 60-year-old man with shoulder pain and a deltoid muscle mass, initially suggestive of an undifferentiated pleomorphic sarcoma. However, further investigations, including radiological findings and muscle biopsy, revealed an unexpected primary lung adenocarcinoma. We performed a systematic literature search to identify the incidence of SMM and reflect on how to improve and build on better diagnosis for entities as atypical as this. This atypical presentation highlights the importance of recognizing and addressing cognitive biases in clinical decision-making, as acknowledging the possibility of uncommon presentations is vital. By embracing a comprehensive approach that combines imaging studies with histopathological confirmation, healthcare providers can ensure accurate prognoses and appropriate management strategies, ultimately improving patient outcomes.

CONCLUSIONS

This case serves as a reminder of the need to remain vigilant, open-minded, and aware of cognitive biases when confronted with uncommon clinical presentations, emphasizing the significance of early recognition and prompt evaluation in achieving optimal patient care.

Measuring the Impact of Primary Care Team Composition on Patient Activation Utilizing Electronic Health Record Big Data Analytics

Purpose

Team-based care has been linked to key outcomes associated with the Quadruple Aim and a key driver of high-value patient-centered care. Use of the electronic health record (EHR) and machine learning have significant potential to overcome previous barriers to studying the impact of teams, including delays in accessing data to improve teamwork and optimize patient outcomes.

Methods

This study utilized a large EHR dataset (n=316,542) from an urban health system to explore the relationship between team composition and patient activation, a key driver of patient engagement. Teams were operationalized using consensus definitions of teamwork from the literature. Patient activation was measured using the Patient Activation Measure (PAM). Results from multilevel regression analyses were compared to machine learning analyses using multinomial logistic regression to calculate propensity scores for the effect of team composition on PAM scores. Under the machine learning approach, a causal inference model with generalized overlap weighting was used to calculate the average treatment effect of teamwork.

Results

Seventeen different team types were observed in the data from the analyzed sample (n=12,448). Team sizes ranged from 2 to 5 members. After controlling for confounding variables in both analyses, more diverse, multidisciplinary teams (team size of 4 or more) were observed to have improved patient activation scores.

Conclusions

This is the first study to explore the relationship between team composition and patient activation using the EHR and big data analytics. Implications for further research using EHR data and machine learning to study teams and other patient-centered care are promising and could be used to advance team science.

Come Roll with Me: An Interprofessional Experience to Promote Disability Awareness

Problem: One in four American adults have a disability, which makes people with disabilities the largest minority group in the United States (U.S.). Chronic diseases are prevalent within this population, which faces myriad barriers that limit access to healthcare and create significant health care disparities. Yet, disability awareness programs are limited in U.S. medical schools and graduates report a sense of unpreparedness to care for this population. Intervention: Come Roll with Me (CRWM) was implemented as an interprofessional, preclinical experience to provide medical and Doctor of Physical Therapy (DPT) students an opportunity to engage with wheelchair users and one another. Students rotated through four stations with a licensed physical therapist and wheelchair user facilitator. Stations included (1) manual wheelchair self-propulsion, (2) accessible parking, (3) transfers, and (4) open dialog on barriers to healthcare led by the wheelchair user. Context: This study sought to assess the impact of CRWM on students' understanding of the barriers and health disparities faced by individuals with disabilities. Assessment was conducted using course evaluations, thematic analysis of student reflection essays and a focus group with the wheelchair user facilitators to determine if CRWM met pre-implementation program goals and objectives, including the Interprofessional Educational Collaborative (IPEC) core competencies. Impact: Student reflections from both disciplines indicated that learners were able to identify a variety of barriers faced by people with disabilities and prioritize methods to mitigate these factors. Approximately 91% of medical students agreed or strongly agreed that CRWM was effective in their learning on course evaluations. Wheelchair user facilitators noted three important outcomes of CRWM: educating, teaming, and impact on students. Lesson Learned: Come Roll with Me is a robust educational activity, as evidenced by the program meeting all goals and objectives as well as (IPEC) core competencies. It provides students a unique opportunity to learn about disability from another profession and wheelchair users. People with disabilities and DPT students are a unique and underutilized pool of educators in undergraduate medical education.

Team Stress and Its Impact on Interprofessional Teams: A Narrative Review

Phenomenon: Interprofessional healthcare team (IHT) collaboration can produce powerful clinical benefits for patients; however, these benefits are difficult to harness when IHTs work in stressful contexts. Research about stress in healthcare typically examines stress as an individual psychological phenomenon, but stress is not only a person-centered experience. Team stress also affects the team's performance. Unfortunately, research into team stress is limited and scattered across many disciplines. We cannot prepare future healthcare professionals to work as part of IHTs in high-stress environments (e.g., emergency medicine, disaster response) unless we review how this dispersed literature is relevant to medical education. Approach: The authors conducted a narrative review of the literature on team stress experienced by interprofessional teams. The team searched five databases between 1 Jan 1990 and 16 August 2021 using the search terms: teams AND stress AND performance. Guided by four research questions, the authors reviewed and abstracted data from the 22 relevant manuscripts. Findings: Challenging problems, time pressure, life threats, environmental distractors, and communication issues are the stressors that the literature reports that teams faced. Teams reacted to team stress with engagement/cohesion and communication/coordination. Stressors impact team stress by either hindering or improving team performance. Critical thinking/decision-making, team behaviors, and time for task completion were the areas of performance affected by team stress. High-quality communication, non-technical skills training, and shared mental models were identified as performance safeguards for teams experiencing team stress. Insights: The review findings adjust current models explaining drivers of efficient and effective teams within the context of interprofessional teams. By understanding how team stress impacts teams, we can better prepare healthcare professionals to work in IHTs to meet the demands placed on them by the ever-increasing rate of high-stress medical situations.

Interprofessional education for healthcare professionals. A BEME realist review of what works, why, for whom and in what circumstances in undergraduate health sciences education: BEME Guide No. 83

AIM

To provide an evidence-informed program theory (PT) for Interprofessional Education (IPE) that adds to the knowledge base of how IPE in undergraduate health sciences education works.

METHODS

We undertook a realist review of the literature and synthesis of the evidence combined with stakeholder experience. Our initial program theory (IPT), built around development, delivery and evaluation of IPE interventions, was tested and refined following an in-depth search of the literature and consultation with stakeholders. The literature (2010-2022) was selected based on the realist criteria of relevance and rigor, as well as on conceptual richness of the studies.

RESULTS

Our PT is built upon 124 CMOs (Context of IPE interventions, Mechanisms that fired within that context, and IPE Outcomes), from 58 studies. Our PT comprises an array of elements found in the Context, including traits and behavioral displays of students and facilitators, and discusses four Mechanisms (feeling responsible, feeling enthusiastic/excited, feeling safe to take risks, and feeling ready), which are likely to lead to outcomes related to the Interprofessional Education Collaborative (sub)competencies.

DISCUSSION

Results were linked to learning theories to further build our understanding. The PT can serve as a guide for the development, delivery, and evaluation of IPE interventions.

Assessing the Efficacy of Active Learning to Support Student Performance Across Undergraduate Programmes in Biomedical Science

Introduction: Active learning is a useful tool to enhance student engagement and support learning in diverse educational situations. We aimed to assess the efficacy of an active learning approach within a large interprofessional first year Medical Cell Biology module taken by six healthcare programmes across the School of Biomedical Sciences at Ulster University, United Kingdom. Materials and methods: An active learning approach was developed for weekly formative assessment using Smartwork to design a weekly interactive multiple-choice quiz to reinforce key concepts specifically for each lecture. We tracked and assessed student performance in the module overall and in each element of course work and exam for 2 years prior to and following the introduction of an active learning strategy to engage and support learning for students from all academic backgrounds and abilities. Results: Full engagement with active learning was significantly associated with an increased overall module performance as well as a significantly increased performance in each element of class test (No engagement vs. Full engagement, p < 0.001), exam (No Engagement vs. Full engagement, p < 0.05) and coursework (No engagement vs. Full engagement, p < 0.001) within this overall total (No Engagement vs. Full engagement, p < 0.01). Partial engagement with active learning was associated significantly improved class test (No engagement vs. partially engaged, p < 0.001) and coursework (No engagement vs. partially engaged, p < 0.05) performance. While a trend toward increased performance in exam and overall module mark was observed, these were not significant. Discussion: Active learning is a useful tool to support student learning across a range of healthcare programmes taken by students with differing backgrounds and academic abilities in an interprofessional and widening participation setting. Student engagement in active learning was highlighted as a key contributory factor to enhanced student performance in all aspects of assessment.

Speech-language pathologist, physical therapist, and occupational therapist experiences of interprofessional collaborations

Interprofessional collaboration among speech-language pathology, physical therapy, and occupational therapy is considered to promote best practice in rehabilitation as it can enhance efficiency, patient outcomes, and clinician and patient satisfaction. Although clinician experiences with interprofessional collaboration have been studied in each of the rehabilitation professions separately, limited research has been conducted on the shared attitudes or experiences across speech-language pathology, physical therapy, and occupational therapy. The purpose of this study was to understand speech-language pathologist, physical therapist, and occupational therapist experiences of interprofessional collaborations. We conducted an exploratory cross-sectional online survey study. The survey included Likert-scale questions and open-ended questions that probed clinicians' general experiences with interprofessional practice and views and beliefs regarding barriers and facilitators to interprofessional collaboration. Responses from 213 clinician respondents were analyzed using descriptive quantitative methods and a qualitative content analysis. The results revealed overlap in attitudes and experiences across speech-language pathology, physical therapy, and occupational therapy about barriers and benefits to interprofessional collaboration. Perceived respect differed among the professions, with speech-language pathologists more frequently reporting that their role is often misunderstood or undervalued by other rehabilitation professionals. These results may guide future research focused upon the predictors of successful interprofessional collaborations and interactions.

Mapping the Landscape: Simulation Centers in Portugal

INTRODUCTION

Simulation-based training has emerged as a vital component of healthcare education. This study aims to characterize Portuguese simulation centers concerning their geographic distribution and key features, providing stakeholders with valuable insights to inform strategic decisions.

METHODS

A cross-sectional survey-based study was conducted over two years (2021-2023) to investigate the geographical dispersion and characteristics of simulation centers in Portugal. Descriptive statistics and thematic analysis were used to analyze data.

RESULTS

Twenty-three Portuguese simulation centers were included. Major urban areas and coastal regions bring together 20 simulation centers (86.96%). A large percentage (71.93%) of centers were affiliated with academic institutions, while five centers (21.74%) were clinically affiliated. Emergency care, Anesthesiology and Intensive Medicine, Pediatrics, and Gynecology and Obstetrics were identified as the national key areas of intervention.

DISCUSSION

Significant geographical disparity raises concerns about unequal access to professional training opportunities using simulation. Centers should be encouraged to incorporate developing technologies and innovative pedagogical methodologies and to expand their training repertoire into relatively uncharted territories.

CONCLUSION

Several issues have been identified within the national simulation network. Stakeholders and policymakers should prioritize equitable access, bolster the prevalence of clinical affiliated centers, foster innovation, and facilitate strategic coordination.

Insights of undergraduate health sciences students about a French interprofessional training initiative

BACKGROUND

Incorporating interprofessional collaboration within healthcare is critical to delivery of patient-centered care. Interprofessional Education (IPE) programs are key to promoting such collaboration. The 'Public Health Service' (PHS) in France is a mandatory IPE initiative that embodies this collaborative spirit, bringing together students from varied health undergraduate training programs-nursing, physiotherapy, pharmacy, midwifery, and medicine- in a common training program focused on primary prevention. The aim of the study was to assess the experience and attitudes of students in the five health training programs regarding the interest of IPEs in the PHS.

METHODS

A cross-sectional survey was administered to 823 students from the 2022-2023 cohort at a French university. The questionnaire was designed with 12 Likert-scale questions specifically created to evaluate the students' experiences, knowledge, and attitudes focused on IPE during the practical seminars, school interventions, and the overall PHS. Additionally, an open-ended question was utilized to gather qualitative data. Statistical analyses assessed satisfaction levels across undergraduate training programs, while thematic analysis was applied to the qualitative responses.

RESULTS

Within the surveyed cohort, 344 students responded to the survey. The findings showed that students were satisfied with the interprofessional collaboration, both in practical teaching sessions (75% satisfaction) and in primary prevention projects conducted in schools (70% satisfaction), despite their having faced challenges with coordination. Pharmacy students, in particular, highlighted the need for adjustments in program scheduling. The qualitative feedback underscored the positive value of IPE, notwithstanding the organizational difficulties stemming from different academic timetables.

CONCLUSION

The student feedback indicated a high level of satisfaction with the interprofessional work carried out in both the practical teaching and the primary prevention projects. To further enhance the educational impact and address the scheduling complexities, it is recommended that program refinements be made based on student feedback and pedagogical best practices.

Behavioural outcomes of interprofessional education within clinical settings for health professional students: A systematic literature review

Interprofessional education facilitates collaborative practice, which promotes high-quality patient care and patient safety. Interprofessional education (IPE) experiences within clinical settings provide an opportunity for the development of interprofessional collaborative practice competence. The aim of this systematic review was to review the literature evaluating interprofessional education for health professional students within clinical settings and summarize the behavioral outcomes. Databases searched were PubMed, Embase, Scopus, Web of Science, Taylor & Francis Online, ERIC and PsycINFO. Full-text articles were independently screened by two reviewers and included if agreed. Outcomes were analyzed using Kirkpatrick's model modified for IPE. Studies with behavioral change outcomes were analyzed and synthesized using narrative methods. Included studies provided evidence that IPE experiences in clinical settings can enable students to develop and integrate interprofessional collaborative practice competencies, across diverse types of settings. Key tasks enabling students to achieve these learning outcomes included synchronous patient consultations, collaborative development of integrative health-care plans outside of patient consultations, and participation in socialization with health-care teams. There were limitations in the methodological design of the included studies, with limited use of comparator groups and validated tools, high usage of self-report data and serious risk of bias identified across all quantitative included studies. In conclusion, high-quality research designed to measure the construct of behavioral change is lacking. Such research could further investigate the key tasks in IPE experiences in clinical settings that are necessary for students to develop the range of required collaborative practice competencies and integrate these. This could provide clarification regarding if and how this could be achieved across different types of clinical placements.

The knowledge, attitudes and perceptions of physiotherapists and chiropractors in South Africa

Background

Effective healthcare delivery occurs when health professionals collaborate and provide holistic, patient-centred care. Physiotherapists and chiropractors treat a common range of patients with an overlap in their scope of practice and modalities because of typical healthcare roles that could lead to 'perceived' animosity.

Objectives

To assess the knowledge, attitudes, and perceptions of qualified chiropractors and physiotherapists regarding each other's practice.

Method

A cross-sectional survey using an online questionnaire and analysed descriptively.

Results

Participants were chiropractors (n = 116) and physiotherapists (n = 190). Chiropractors achieved a mean knowledge score of 75.7%, with physiotherapists at 59.7% on the assessments of each other's patients; an average score of 85.3% and 72.0% respectively, on knowledge of treatment modalities; knowledge score of 82.4% and 77.3% respectively, on the conditions treated by the other professional. A total of 82.8% (n = 96) of chiropractors and 70.0% (n = 133) of physiotherapists indicated the other professionals' competence in treating neuromusculoskeletal conditions. Inter-professional referrals occurred between 81.9% of chiropractors (n = 95) and 55.3% of physiotherapists (n = 105). Chiropractors (69.0%, n = 80) and physiotherapists (55.3%, n = 105) wanted to collaborate to manage patients.

Conclusion

In the surveyed population in South Africa, chiropractors and physiotherapists had good knowledge, positive attitudes and perceptions of each other's practices, especially in the private sector.

Clinical implications

Inter-professional collaboration between chiropractors and physiotherapists should be encouraged so that healthcare delivery can be holistic and patient-centred for better clinical outcomes.

Validation of an interprofessional education search strategy in PubMed to optimize IPE literature searching

Objective

With exponential growth in the publication of interprofessional education (IPE) research studies, it has become more difficult to find relevant literature and stay abreast of the latest research. To address this gap, we developed, evaluated, and validated search strategies for IPE studies in PubMed, to improve future access to and synthesis of IPE research. These search strategies, or search hedges, provide comprehensive, validated sets of search terms for IPE publications.

Methods

The search strategies were created for PubMed using relative recall methodology. The research methods followed the guidance of previous search hedge and search filter validation studies in creating a gold standard set of relevant references using systematic reviews, having expert searchers identify and test search terms, and using relative recall calculations to validate the searches' performance against the gold standard set.

Results

The three recommended search hedges for IPE studies presented had recall of 71.5%, 82.7%, and 95.1%; the first more focused for efficient literature searching, the last with high recall for comprehensive literature searching, and the remaining hedge as a middle ground between the other two options.

Conclusion

These validated search hedges can be used in PubMed to expedite finding relevant scholarships, staying up to date with IPE research, and conducting literature reviews and evidence syntheses.

Exploring differences in and factors influencing self-efficacy for competence in interprofessional collaborative practice among health professions students

The value of health care delivered via effective interprofessional teams has created an imperative for interprofessional education (IPE) and interprofessional collaborative practice (ICP). To inform IPE strategies, we investigated differences in perceived self-efficacy (SE) for competence in ICP among health professions students. The study data were collected between 2015 and 2019 from students from 13 different health professions programmes (N = 3,497) before an annual institutional interprofessional programme. Students completed the IPECC-SET-27, a validated instrument evaluating perceived SE for competence in ICP, and rated their 1) amount of previous contact with, and 2) perceived understanding of, the role of different health professions. Students in different health professions education programmes were compared using parametric statistics. Regression analyses explored factors influencing SE for competence in ICP. Findings revealed significant differences in perceived SE for competence in ICP between programmes (p < .05). Specifically, health information management/health informatics, dentistry, medicine, and nursing students expressed relatively higher SE, whereas physical therapy and occupational therapy students expressed relatively lower SE. Perceived understanding of the role of health professions (p < .01) and gender (p < .01) contributed significantly to predicting perceived SE for competence in ICP, while the amount of previous contact with other health professions did not (p = .42). The findings highlight the value of designing IPE with consideration of specific learner needs.

A Cytomegalovirus (CMV) Case Study to Promote Interprofessional Learning (IPL) Between Audiology and Biomedical Science Students in Higher Education

Modern and effective patient care requires specialist healthcare professionals working together. Interprofessional learning (IPL) seeks to provide opportunities for different healthcare disciplines to learn with, from and about each other. This study focused on the delivery and evaluation of a cytomegalovirus (CMV) case study workshop to facilitate IPL between two Health and Care Professions Council (HCPC) regulated courses: Biomedical Science and Audiology. The 2 h online workshop consisted of 1) defining the roles, responsibilities and skills of the two healthcare professions, 2) the structure of the Biomedical Science and Audiology departments, 3) routes to HCPC registration, 4) core curriculum of both degree programmes and 5) interpreting interdisciplinary data related to a CMV patient case. The workshop was interactive, with the virtual learning environment promoting peer discussions and the use of online polling. Student responses were collected through an online questionnaire. A total of 108 respondents completed a post-event survey and Mann-Whitney U tests revealed there were no significant differences in the responses between the two student cohorts in response to each of the survey statements (p > 0.05). A total of 82.4% of students agreed that they need to know the role of other healthcare professionals for their future practice, whilst 84.2% agreed that the CMV case study was a good format to facilitate effective IPL. A total of 93.5% of respondents recognised the importance of both professions in diagnosing a patient with CMV. Thematic analysis identified four common themes, including appreciation of shared roles, recognition of similarities in registration pathways, working together to provide holistic patient care and the role of clinicians in the patient journey. This novel collaboration between Biomedical Science and Audiology facilitated effective IPL whilst meeting the interprofessional education HCPC requirements. Collaborative working is an essential component of delivering effective patient care and allied healthcare degrees need to provide opportunities within their curriculum to foster this. We hope this study encourages other higher education institutes to expand and develop their current IPL activities to include a broader spectrum of healthcare courses.

Effectiveness and feasibility of an interprofessional training program to improve patient safety-A cluster-randomized controlled pilot study

Introduction

Interprofessional healthcare teams are important actors in improving patient safety. To train these teams, an interprofessional training program (IPTP) with two interventions (eLearning and blended learning) was developed to cover key areas of patient safety using innovative adult learning methods. The aims of this study were to pilot test IPTP regarding its effectiveness and feasibility. The trial was registered with DRKS-ID: DRKS00012818.

Methods

The design of our study included both a pilot investigation of the effectiveness of the two interventions (eLearning and blended learning) and testing their feasibility (effectiveness-implementation hybrid design). For testing the effectiveness, a multi-center cluster-randomized controlled study with a three-arm design [intervention group 1 (IG1): eLearning vs. intervention group 2 (IG2)]: blended learning (eLearning plus interprofessional in-person training) vs. waiting control group (WCG) and three data collection periods (pre-intervention, 12 weeks post-intervention, and 24 weeks follow-up) was conducted in 39 hospital wards. Linear mixed models were used for the data analysis. The feasibility of IPTP was examined in 10 hospital wards (IG1) and in nine hospital wards (IG2) using questionnaires (formative evaluation) and problem-focused interviews with 10% of the participants in the two intervention groups. The collected data were analyzed in a descriptive exploratory manner.

Results

Pilot testing of the effectiveness of the two interventions (eLearning and blended learning) showed no consistent differences between groups or a clear pattern in the different outcomes (safety-related behaviors in the fields of teamwork, error management, patient involvement, and subjectively perceived patient safety). Feasibility checks of the interventions showed that participants used eLearning for knowledge activation and self-reflection. However, there were many barriers to participating in eLearning, for example, lack of time or access to computers at the ward. With regard to in-person training, participants stated that the training content sensitized them to patient-safety-related issues in their everyday work, and that awareness of patient safety increased.

Discussion

Although the interventions were judged to be feasible, no consistent effects were observed. A possible explanation is that the duration of training and the recurrence rate may have been insufficient. Another conceivable explanation would be that participants became more sensitive to patient safety-critical situations due to their knowledge acquired through the IPTP; therefore, their assessment post-intervention was more critical than before. In addition, the participants reported high pre-measurement outcomes. Future studies should examine the evidence of the intervention within a confirmatory study after adapting it based on the results obtained.

Evidence of successful interprofessional education programs-models, barriers, facilitators and success: a systematic review of European studies

PURPOSE

Interprofessional education (IPE) has been highly promoted as a means of enhancing interprofessional practice and thereby having a positive impact on healthcare systems and patient outcomes. Various documents mention that sufficient evidence has been accumulated to demonstrate the effectiveness of IPE, yet it is not completely clear what type of evidence is being alluded to. The objective of this review was to gather evidence about IPE programs that resulted in effective long-term outcomes in healthcare. Secondary outcomes included identification of the types of models that met the success criteria, barriers and facilitators of such successful programs if any.

DESIGN/METHODOLOGY/APPROACH

A systematic search was conducted in PubMed, Web of Science, CINAHL and Scopus. The review considered studies that targeted undergraduate and postgraduate students among more than one health profession and included those in the English language published between 2010 and end of 2020.

FINDINGS

Five studies have been identified and described in this review. These papers evaluated different IPE programs and models.

RESEARCH LIMITATIONS/IMPLICATIONS

1. This systematic review investigated the evidence of the existence of IPE programs and the findings show there is no robust specific evidence of long-term impact on healthcare and on patients' outcomes. 2. The conclusion from this review is that it is still unclear what format constitutes a successful and efficient program. 3. Appropriate longitudinal studies need to be designed to identify the impact of IPE on long-term health outcomes.

ORIGINALITY/VALUE

Overall, the studies show that although there is an emphasis on practice-based learning, there is no robust specific evidence of long-term impact on healthcare and on patients' outcomes. Appropriate longitudinal studies need to be designed to identify the impact of IPE on long-term health outcomes.

Evaluation of an interprofessional education intervention in partnership with patient educators

BACKGROUND AND AIM

Patient involvement in interprofessional education is a novel approach to building collaborative and empathic skills in students. However, this area of teaching is lacking in rigorous studies. The project aimed to evaluate whether an interprofessional education intervention in partnership with patient educators (IPE-PE) would increase readiness for interprofessional learning and empathy in health sciences students.

METHODS

This is the report of a didactic innovation project. Participants included 310 undergraduate health sciences students who took part in an IPE-PE intervention. Data were collected before and after the training, using the Readiness for Interprofessional Learning Scale (RIPLS) and the Jefferson Scale of Empathy-Health Professions Student version (JSE-HPS). Only at the end of the intervention, a data collection form was administered to explore the value of the patient educator in the training and to investigate the socio-demographic variables.

RESULTS

The mean age of participants was 21±3.2 SD years and 76% were female. A paired t-test showed significant changes from before to after the IPE-PE in the mean total RIPLS score (42.7±5.8 SD vs 44.62±5.9 SD, P<0.001) and the mean total JSE-HPS score (112.7±12.5 SD vs 116.03±12.8 SD, P<0.001).            Conclusions: Our students reported that IPE-PE had helped them to become more effective healthcare team members, to think positively about other professionals, and to gain empathic understanding of the perspective of the person being cared for. The results of the project confirm that the intervention promoted the development of empathy, fostering a better understanding of the patient-centred perspective.

The state of undergraduate palliative care education at Austrian medical schools - a mixed methods study

BACKGROUND

There is an increasing demand for universal, high-quality access to palliative care in Austria. To ensure this, the implementation of palliative care in the medical studies curriculum is essential. This is the first study to investigate the state of undergraduate palliative care education at Austrian medical schools.

METHODS

For this mixed-methods study with concurrent embedded design, expert interviews and online surveys were conducted between March and August 2022. The interviews were subjected to a thematic analysis according to Braun and Clarke, while the questionnaires were analysed descriptively-statistically. For the final integration, the results of both methods for each topic are presented and discussed complementarily. Both the primary qualitative and supportive quantitative data were collected to combine the advantages of the in-depth nature of the qualitative data and the consistent structure of the quantitative data to provide a more precise representation of the state of teaching.

RESULTS

Twenty-two persons participated in the study, of whom twenty-one participated in the interview and eight in the questionnaire. The participants were experts in palliative care teaching at Austrian medical schools. Currently, palliative care is taught at seven out of the eight universities. Large differences were found in the number of hours, organisation, teaching formats, and interprofessional education. At present, three universities have a chair for palliative care and at least five universities have access to a palliative care unit.

CONCLUSION

Undergraduate palliative care education in Austria is very heterogeneous and does not meet the minimum standards suggested by the European Association for Palliative Care (EAPC) curriculum recommendations. However, several universities are planning measures to expand palliative care teaching, such as the introduction of mandatory teaching or the establishment of new teaching formats. Better coordination and networking within and between universities would be beneficial for the expansion and quality of teaching.

FINCA - a conceptual framework to improve interprofessional collaboration in health education and care

The health care system in Germany and in many other countries is facing fundamental challenges due to demographic change, which require new integrated care concepts and a revision of the collaboration between health care professions in everyday clinical practice. Internationally, several competency framework models have been proposed, but a framework that explicitly conceptualizes collaborative activities to improve interprofessional problem-solving competency in health care is still missing. Such a framework should define contextual, person-related, process-related, and outcome-related variables relevant to interprofessional problem solving in health care. Against this background, we present a conceptual framework to improve interprofessional collaboration in health education and care (FINCA) developed with scientific consideration of empirical data and various theoretical references. FINCA reflects an interprofessional learning and interaction process involving two persons from different health care professions and with different individual learning prerequisites. These two initially identify a problem that is likely to require interprofessional collaboration at some point. FINCA acknowledges the context of interprofessional learning, teaching, and working as well as its action-modifying context factors. We follow the reasoning that individual learning prerequisites interact with the teaching context during learning activities. At the heart of FINCA are observable collaborative activities (information sharing and grounding; negotiating; regulating; executing interprofessional activities; maintaining communication) that can be used to assess individuals' cognitive and social skills. Eventually, the framework envisages an assessment of the outcomes of interprofessional education and collaboration. The proposed conceptual framework provides the basis for analysis and empirical testing of the components and variables it describes and their interactions across studies, educational interventions, and action-modifying contexts. FINCA further provides the basis for fostering the teaching and learning of interprofessional problem-solving skills in various health care settings. It can support faculty and curriculum developers to systematize the implementation and improvement of interprofessional teaching and learning opportunities. From a practical perspective, FINCA can help to better align curricula for different health professions in the future. In principle, we also see potential for transferability of the framework to other areas where different professions collaborate.

Development of the PREMIUM computerized adaptive testing for measuring the access and care coordination for patients with severe mental illness

Severe mental illness (SMI) patients often have complex health needs, which makes it difficult to access and coordinate their care. This study aimed to develop a computerized adaptive testing (CAT) tool, PREMIUM CAT-ACC, to measure SMI patients' experience with access and care coordination. This multicenter and cross-sectional study included 496 adult in- and out-patients with SMI (i.e., schizophrenia, bipolar disorder, or major depressive disorder). Psychometric analysis of the 13-item bank showed adequate properties, with preliminary evidence of external validity and no substantial differential item functioning for sex, age, care setting, and diagnosis, making it suitable for CAT administration. A post-hoc CAT simulation demonstrated that the tool was efficient and accurate, with an average of seven items, compared to the full item bank administration. Its use by clinicians can contribute to optimizing patient care pathways and transitioning towards more person-centered healthcare.

Interprofessional education: a necessity in Alzheimer's dementia care-a pilot study

Introduction

Interprofessional collaboration is seen as an indispensable prerequisite for high-quality health services and patient care, especially for complex diseases such as dementia. Thus, the current project aimed to extend interprofessional and competency-based education in the field of dementia care to the previously understudied therapy professions of nutrition, speech-language pathology, and physiotherapy.

Methods

A three-day workshop was designed to provide specific learning objectives related to patient-centered dementia care, as well as competences for interprofessional collaboration. Teaching and learning approaches included case-based learning in simulated interprofessional case-conferences and peer-teaching. A total of 42 students (n = 20 nutrition therapy and counseling, n = 8 speech-language pathology, n = 14 physiotherapy), ranging from first to seventh semester, finished the whole workshop and were considered in data analysis. Changes in self-perceived attitudes toward interprofessional collaboration and education were measured by the German version of the UWE-IP. An in-house questionnaire was developed to evaluate knowledge and skills in the field of dementia, dementia management and interprofessional collaboration.

Results

Participation in the workshop led to significant improvements in the total scores of the UWE-IP-D and the in-house questionnaire, as well as their respective subscales. Moderate to large effect sizes were achieved. All professions improved significantly in both questionnaires with large effect sizes. Significant differences between professions were found in the UWE-IP-D total score between students of speech-language pathology and physiotherapy in the posttest. Students of nutrition therapy and counseling revealed a significant lower level of self-perceived knowledge and skills in the in-house questionnaire pre- and post-testing.

Discussion

The pilot-study confirms the effectiveness of interprofessional education to promote generic and interprofessional dementia care competencies and to develop positive attitudes toward interprofessional learning and collaboration in the therapy professions, thus increasing professional diversity in interprofessional education research. Differences between professions were confounded by heterogenous semester numbers and participation conditions. To achieve a curricular implementation, interprofessional education should be expanded to include a larger group of participants belonging to different professions, start early in the study program, and be evaluated over the long term.

Academic emotions and attitudes regarding interprofessional collaboration in health care activities: a prospective study among newly arrived physicians participating in a fourteen-week course

BACKGROUND

One way of facilitating entrance into the Swedish health care system, for newly arrived physicians from outside the European Union/European Economic Area, could be to set up and offer a course aimed to enhance understanding of it. This course was offered to increase insight about clinical practices, interprofessional teamwork and topics such as, Swedish health care laws, culture, and ethics. Acceptance of, and a flexible attitude towards, interprofessional teamwork are important for maintaining both the physician's professional identity and a high quality of patient care. The aim of this study was to investigate newly arrived physicians', academic emotions, experience of stress and flow during a fourteen-week course, as well as attitudes to interprofessional collaboration, both before and after.

METHOD

A prospective study was conducted, with participants asked to respond on one questionnaire every course day, by using the Contextual Activity Sampling System methodology. The participants were asked to complete a questionnaire comprising ten questions about ongoing activity and in what way they experience, e.g., collaboration, interprofessional teamwork, academic emotions, flow, and stress. Furthermore, the participants were asked to score their attitude towards interprofessional teamwork by using the interdisciplinary education perception scale both before and after the course.

RESULTS

The total sample comprised 27 qualified physicians, from outside the European Union/European Economic Area. In the interdisciplinary education perception scale category, "perception of actual cooperation¨, the participants had significantly higher scores after the course. Flow and academic emotions were felt mostly during own periods of study, seminars, and lectures. The academic emotions were apathy, anxiety, and boredom. The most frequently experienced academic emotion was apathy. Course participants rated stress highest in connection with the examination.

CONCLUSION

The results show that the course had a positive impact on the participants perception of actual cooperation. It appears that participating in this kind of course was a positive experience for the participants, since they mostly experienced high levels of flow. Collaborating with others was experienced as positive, with participants reporting a high degree of flow in activities during collaboration.

Integration of hospital and community care for paediatric ophthalmology: A mixed-methods study

BACKGROUND

To explore collaborative care models for paediatric eye care that integrate hospital and community-based care to address access blocks.

METHODS

Sequential referrals to a tertiary paediatric ophthalmology clinic between April and October 2019 and subsequent encounters up until July 2020 at a major metropolitan public children's hospital in Sydney, Australia, were reviewed to identify those cases suitable for community care. Semi-structured phone interviews were conducted with eye health service providers, including ophthalmologists, orthoptists and optometrists, as well as service users to explore their perspectives on potential changes to service delivery. Qualitative data were analysed deductively using the Levesque model for access to healthcare and Consolidated Framework for Implementation Research (CFIR) to inform implementation strategies for future models of care.

RESULTS

One-third of the 439 audited referrals (30.5%; 134/439) were identified as suitable for community management. Interviews revealed five themes relating to potential models of care, which would support and promote access: integrated health systems, standardised quality of care, interprofessional trust, multidisciplinary governance and patient-centred care. Key recommendations for future implementation included: (i) identifying and preparing clinical champions, (ii) conducting educational meetings, (iii) conducting local needs assessments and (iv) informing local opinion leaders.

CONCLUSIONS

This audit highlights access blocks and poor targeting of referrals to tertiary paediatric ophthalmology services in a metropolitan hospital. Integration with community practitioners was identified as an acceptable way to streamline services, and strategies that may support successful implementation in this setting were identified.

Determining the impact of an interprofessional learning in practice model on learners and patients

The Institute of Medicine recently expressed a need to measure the impact of interprofessional education (IPE) on health professions collaborative behavior in practice environments and patient outcomes, and the National Center for Interprofessional Practice and Education has focused research efforts to connect interprofessional practice and education. We describe a model intentionally designed to link interprofessional practice experience in ambulatory care setting and an IPE curriculum for students, called the Interprofessional Learning in Practice (ILIP) model. The study objective was to determine the impact of the ILIP model on student and patient outcomes during a 24-month intervention period. Student satisfaction was collected through a brief survey administered post-ILIP model. Patient outcomes were collected from before and after the intervention period through a retrospective chart review of patients who received care through the ILIP model. For the study, disease indicators for the top three chronic diagnoses of depression, hypertension, and type 2 diabetes mellitus were chosen as the patient outcomes. Student outcomes were analyzed using descriptive statistics and the Mann-Whitney U test. Patient outcomes were analyzed using McNemar's test and paired t-tests. Of the 382 students who participated in the ILIP model during the study period, 179 completed surveys, indicating that they valued the experience, valued learning from interprofessional preceptors, and gained interprofessional skills to use in their future practice. During the 24-month intervention, 401 patients were evaluated post-ILIP model, statistically significant results demonstrated HbA1c values for patients with diabetes were reduced by 0.5% and depression screening improved from 9% to 91%. Additionally, patients' hypertension control was similar to baseline and diabetes control (as defined as HbA1c ≤8%) was improved compared to baseline but did not reach statistical significance. By aligning interprofessional practice and education in the ILIP model, students had a positive experience, gained interprofessional collaboration skills, and provided value-added benefits to improve patient outcomes.

Reliability and validity of the Taiwanese version of the collaborative practice assessment tool: A pilot study

Objectives

To promote teamwork communication and collaboration between health-care professionals, educators emphasized proper training programs to develop interprofessional collaborative practice (IPCP) among postgraduate (PG) trainees. A literature review indicated that the faculty necessarily measured the competency in IPCP with structured and applicable assessment tools in collocation to training programs domestically. A cross-sectional psychometric study was conducted to construct a reliable assessment tool for measuring PG learning outcome in Taiwan through a bidirectional translation. The study aimed to assess the interprofessional team behavior of trainees using the Taiwanese version of the collaborative practice assessment tool (T-CPAT).

Materials and Methods

The study recruited 43 participants to undergo a PG training program in a single institute and to complete T-CPAT. Data were analyzed using SPSS 22.0 software. We employed descriptive analysis of demographic variables. The validity of T-CPAT was analyzed by experts in different specialties and its availability was assessed by item-level analysis. Furthermore, the T-CPAT reliability was tested using Cronbach's α.

Results

The average score was 305.2 (standard deviation = 38.08), and the expert validity of the T-CPAT was 0.96. In the item-level analysis, there were no failure items in T-CAPT. Cronbach's α reached 0.94 (95% confidence interval = 0.90-0.96).

Conclusion

The study demonstrated good reliability and validity for the T-CPAT. Thus, the T-CPAT can be used to accurately measure and assess the competence of IPCP in PG trainees in general medicine in Taiwan. The results were deemed sufficient to provide faculties with related arrangements for future teaching plans.

A History of Musculoskeletal Medicine and Its Place and Progress in Undergraduate Medical Education

Musculoskeletal diseases are responsible for some of the most prevalent conditions affecting population health in the world. Despite the prevalence of these conditions, musculoskeletal medicine has a fraught history within the world of undergraduate medical education. We review the origins of musculoskeletal medicine, its evolution in undergraduate medical education, and progress that has been made over the last decade as a result of global initiatives such as the Bone and Joint Decade. Understanding the history of musculoskeletal medicine is essential to contextualizing the problems that exist today and creating comprehensive solutions to fill the gaps that persist in musculoskeletal curricula.

Attitudes of health care professionals towards interprofessional teamwork in Ashanti Region, Ghana

BACKGROUND

Interprofessional collaboration ensures that high-quality health care is provided leading to improved health outcomes and provider satisfaction. Assessing the attitudes of health care professionals towards teamwork in Ghana is novel.

OBJECTIVE

To examine the attitudes of health care professionals towards interprofessional teamwork and assess specific attributes influencing these attitudes in the Ashanti region, prior to implementing an in-service interprofessional HIV training programme.

METHODS

A cross-sectional pre-training online survey using a modified Attitudes Toward Health Care Teams Scale was conducted among health care practitioners undergoing a two-day interactive interprofessional HIV training in Kumasi and Agogo from November 2019 to January 2020. Trainees were diverse health professional cadres selected from five hospitals in the Ashanti region of Ghana. Data was summarised using the mean and standard deviation for continuous variables, and frequencies and percentages for categorical variables. An exploratory factor analysis was conducted to categorise the 14 items of the modified attitudes scale. The Wilcoxon rank-sum (Mann-Whitney) and Kruskal-Wallis tests were used to test the mean attitude difference among the demographic characteristics. Statistical significance was set at p < 0.05.

RESULTS

Altogether, 302 health professionals completed the survey. The ages ranged from 20-58 years, mean age 27.96 years (standard deviation 5.90 years). Up to 95% of the trainees agreed with the 14 statements on the modified attitudes scale. Three factors were identified; "quality of care", "team efficiency", and "time constraint" with Cronbach's alpha measures of 0.73, 0.50, and 0.45 respectively. The overall mean attitude score was 58.15 ± 6.28 (95% CI, 57.42-58.88). Attitude of health care professionals towards interdisciplinary teams for patient care varied significantly by age (p = 0.014), health profession cadre (p = 0.005), facility (p = 0.037), and professional experience (p = 0.034).

CONCLUSION

Strengthening in-service interprofessional training for health practitioners especially early career professionals in the Ashanti region would be valuable.